The Analysis Of Clinical Manifestation With 50 Cases Of Top Of The Basilar Syndrome

Objective: The conception of Top of the Basilar Syndrome(TOBS),was named by Caplan in 1980.Refers to the blood circulation barrier of the corresponding blood supply area caused by ischemia or occlusion of the basilar artery,clinical in the thalamus,midbrain,cerebellum,occipital lobe,temporal lobe infarction side is a group of syndrome manifestations.The incidence rate of TOBS is low,but dangerous disease,high mortality and poor prognosis.In this study,through the analysis of risk factors,the clinical manifestations,imaging characteristics,complication and prognosis of TOBS patients,in order to improve the cognition of clinicians on TOBS,achieve early diagnosis,early treatment and better prognosis.Method: We studied a cohort of 50 cases of TOBS patients from Department of Neurology of the second hospital of Hebei Medical University between June 2015 to October 2016.All the patients met the diagnostic criteria of cerebral infarction developed by the fourth national Cerebrovascular Disease Conference in 1995.All the TOBS patients were confirmed by CT or MRI.Statistical analysis was carried out on the clinical data for risk factors,etiology,clinical symptoms,physical signs,auxiliary examination complication and prognosis of TOBS patients.Result:1 The main risk factors of TOBS were identified as hypertension,smoking or dinking alcohol,hyperlipidemia,hyperhomocysteinemia,diabetes,heart disease,Cerebral infarction and TIA history.The most common cause of TOBS was cerebral embolism.2 The most common clinical manifestation was consciousness disorder,followed by whilst disorders of ocular movement,abnormal pupil,movement disorders,behavioral and cognitive disorders,speech disorders,blindness orcortical blindness,vertigo,sensory disturbance.3 Various anatomical locations ranged from a frequency from high to low as follows:thalamus,cerebellum,midbrain,occipital lobe,temporal lobe,pons.4 The main complications of TOBS patients were infection,mainly due to lung infection and urinary tract infection.followed by hypoproteinemia,electrolyte,acid-base balance disorder,stress ulcer,lower extremity venous thrombosis.5 During the admission of these patients in hospital,21 of the 50 TOBS patients witnessed improvement,29 cases had poor prognosis,and8 of them died.Conclusion:1 The most common risk factor of TOBS is hypertension,and cerebral embolism is the main cause of the disease.2 The clinical manifestations of TOBS are complex and diverse,and different parts of the affected,there will be different clinical manifestations,one of the most common symptoms is the consciousness disorders and whilst disorders of ocular movement,but it is not necessarily in diagnosis.3 Clinicians should pay attention to the thorough physical examination,when patients are presented to hospital,the MRI,DWI,MRA or CT,CTA examination should be done as soon as possible,To achieve early diagnosis in order to avoid missed diagnosis.4 Top of the Basilar Syndrom has poor prognosis,hign mortality and disability rate,and the occurrence of complications can aggravate the condition and influence the prognosis.